Healthcare professionals' experiences involving Aboriginal families in the paediatric ESCALATION system.

The Western Australian paediatric ESCALATION system, integrating family involvement, promotes early recognition and response to a hospitalised child's deteriorating health. This study aimed to understand healthcare professionals' experiences of Aboriginal parent/carer involvement in detecting clinical deterioration in the hospital. This interpretive descriptive study is stage one of a multisite three-staged pre-post intervention study guided by the Practical, Robust Implementation, and Sustainability Model (PRISM). Healthcare professionals (nurses and doctors) from three hospitals involved with the care of Aboriginal children were invited to participate in focus groups or interviews. Seventy-two healthcare professionals participated, with recordings transcribed and analysed using reflexive thematic analysis. Four themes mapped to the PRISM framework described their experiences: Interpreting family concern (Organisational Characteristic/Perspective), Building a relationship (Implementation & Sustainability Infrastructure), Recognising communication barriers (Implementation & Sustainability Infrastructure), and Culturally secure care is a shared responsibility (External Environment). Findings highlighted that healthcare professionals valued Aboriginal families' role in recognising deterioration. Effective Aboriginal family involvement in the ESCALATION system relies on strong healthcare professional and family relationships, Aboriginal Liaison Officer support, and cultural awareness with appropriate communication. Findings will inform tailored solutions to strengthen Aboriginal family engagement in escalating care.